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DRAFT MINUTE of MEETING of the
ALLIED HEALTH PROFESSIONS COMMITTEE
Board Room, Assynt House,Inverness – 2.35 pm /
Tuesday 29 September 2009
Present: / Judith Catherwood, Associate Director (AHPs) (JC) (In the Chair)Maria Dickson, AHP Lead, Raigmore Hospital (MD)
Iain Henderson, Orthotics (IH)
Heidi May, Director of Nursing (HM)
Mary MacLeod, Podiatry (MMcL) (Videoconference from 2.50pm)
Jean McCulloch, Orthoptics (JM)
Margaret Moss, Nutrition and Dietetics (MM)
Kayrin Murray, Speech and Language Therapy (KM) (from 2.40pm)
Dougal Sim, Physiotherapy (DS)
Katherine Sutton, Radiography (KS)
Claire Wood, Occupational Therapy (CW)
In Attendance / Dr Roger Gibbins, Chief Executive (RG)
Brian Mitchell, Board Committee Administrator (BCA)
1. / APOLOGIES
Apologies were received from Diane Brawn, Evelyn Ogilvie, Rhiannon Pitt, and Derek Ritchie.
2. / MINUTE OF MEETING HELD ON 5 JUNE 2009
The Minutes of the meetings held on 17 March and 5 June 2009 were Approved. / BCA
3. / MATTERS ARISING
3.1 Practice Education Facilitators (PEF) Programme
Ms Catherwood advised that the Practice Education Coordinator post would be submitted to the Vacancy Committee meeting to be held on 8 October 2009. The post would be 0.7wte and relevant Job Description, Agenda for Change banding etc had been completed. It was anticipated that the post would be advertised in October, 2009 with interviews in November and a start date in January 2010.
The Committee Noted the position.
4. / NHS HIGHLAND BOARD STRATEGY AND CORPORATE OBJECTIVES 2009/2010
Dr R Gibbins spoke to the circulated report and associated documentation relating to the future vision and aims of NHS Highland, based on the changing health needs of local people together with the macro economic climate, and the consequent need to adapt healthcare services. Work in this area had been developed and expressed in a new overall vision for patients and local people using the three aims of Better Health, Better Care and Better Value (BHBCBV) which together describe the organisational purpose, focus, and priorities. The circulated report outlined the commitments, challenges and opportunities this presented to NHS Highland and the key areas of responsibility were detailed for Executive Directors and other key leaders; Operational Leaders and Managers; all NHS Highland staff; patients, carers, and public; and also the media. Dr Gibbins spoke to the Vision and Aims document and advised that in simple terms the aim was to provide the best care for patients at every opportunity and embedding this approach throughout the organisation. This required the successful balancing of the ‘triple aim’ of Better Health, Better Care, and Better Value. Dr Gibbins referred to the Board Improvement Programme 2009/2010 paper stating that there were five main themes, each of which had several component workstreams, and these would be Planned Care; Anticipatory Care; Unscheduled Care; equity, quality, consistency, and standards of care; and an Efficiency Programme. It was stated that change should only be introduced in the context of a defined purpose and overall this Programme would seek to achieve efficiencies and subsequently free resource from within and re-invest to meet current and planned improvements. There had also been circulated document defining the Corporate Objectives for NHS Highland in 2009/2010 and Dr Gibbins stated that this should be used as a common tool for Objective setting at both team and individual level. This would ensure that activity is aligned to the areas important to the organisation at this time. Overall Strategy success would require strong connectivity across the range of issues involved and such connectivity required to be emphasised at all levels.
During discussion, it was stated that staff required to be aware of and supported through any change process and Dr Gibbins sought the views of the Committee on how the NHS Board could help in this area and achieve the desired aims. Ms H May advised that Committee members would be crucial in providing relevant leadership and support in this area. She stated that having attended an SPSP masterclass, with the Chief Operating Officer and Head of Clinical Governance and Risk Management, clear links had been established between quality care and associated efficiencies; this being a key element of the proposed change process. As such a report on this activity would be submitted to both this and the Area Nursing and Midwifery Advisory Committee (ANMAC). The view was expressed that balancing the various strands of BHBCBV would be a difficult message to impart to staff, especially providing the link for staff by illustrating the implications of change and how this would bring organisational benefits. Whilst these messages were filtering through to front line staff, there would be a need for individual staff members to think differently within their respective roles, and where appropriate, challenge existing learned behaviour. It was agreed that staff required to appreciate their own role within this overall change process and that engagement would be key to achieving this. One view expressed stated that whilst it was relatively straightforward to explain to staff what the organisation would like to achieve the more difficult message related to that activity that would require to cease to enable that to take place, the need for role development and service reconfiguration. Dr Gibbins stated that the links evidenced in BHBCBV should provide illustration of that interconnectivity and show how decisions can and would impact on other areas and organisational aspects. There was a need for staff to understand their own role within this process and the organisation as a whole.
Ms Catherwood stated that emphasising the ‘whole system’ approach of BHBCBV to staff, and establishing the required links across professions, services, and geographical areas would be a major challenge. In this regard Dr Gibbins advised that the NHS Board were focussed on this activity, including the relevant issues and were fully committed to achieving required change. Where there was organisational resistance to such change it was anticipated this would be challenged where appropriate. He stated that part of the role of management would be to support staff through change processes, that this also formed part of the role of the staffside representatives and as such managers should utilise this resource during discussions etc. The view was expressed that individuals may find it a challenge to identify where they can make a difference, or influence change, and Ms H May advised that there were strong escalation processes in place and as such these should be utilised where appropriate to assist.
After discussion, the Committee:
· Noted the NHS Highland Board Strategy and Corporate Objectives 2009/2010.
· Noted Corporate Objectives should be utilised in objective setting exercises at both team and individual level.
· Noted that staff side representation and escalation processes should be utilised where appropriate during the change process. / HM
ALL
ALL
5 / DRAFT NHS HIGHLAND BOARD MEETING AGENDA – 6 OCTOBER 2009
There had been circulated Agenda relative to the NHS Board meeting to be held on 6 October 2009. Ms J Catherwood requested that members consider the relevant papers, to be circulated by the Committee Administrator, and highlighted the following individual Items:
· 5.2 – Mental Health Services in Argyll and Bute. Dr R Gibbins advised the Cabinet Secretary had agreed to redevelopment of services, including the acute in-patient pathway. A number of Working Groups had been established.
· 5.3 – Vision for the Vale of Leven. Dr R Gibbins advised the NHS Greater Glasgow and Clyde vision was for maximisation of medical service provision, increased clinic provision, and improvements in Mental Health services through provision at Gartnavel etc. A monitoring group was to be established.
The Committee Noted relevant comments should be relayed to Ms Catherwood.
6. / REVIEW OF COMMITTEE ARRANGEMENTS
Ms J Catherwood spoke to the circulated report relating to a proposal to develop an Area Nursing, Midwifery and Allied Health Professions Advisory Committee and thereby increase opportunities for NMAHPs to influence the delivery of patient services across NHS Highland. This proposal would also seek to strengthen the advisory function of the Committee, improve the ability of NMAHPs to influence national or NHS Board policy, and provide coordinated and robust professional input to the Area Clinical Forum and NHS Board. The new Committee would be would be constituted with an advisory, steering and assurance function. Three new Sub Groups would be established and would report to the joint Committee to enable it to fulfil the steering and assurance function. These Sub Groups would relate to Professional Policy, Research and Development, and Workforce Planning and Development. The Committee Agenda would consist of two clear elements and these would relate to the advisory role and to the steering and assurance role. Proposed membership of the new Committee would be drawn from the professions and practice areas within NHSH, with one elected member from each AHP profession and one from each branch/area of nursing and midwifery practice. Membership was proposed as a three year term, with the option for re-election thereafter. The joint Committee would have separate Chairs for each of the separate functions, with one member elected by the Committee for the advisory element, and the other Chaired by the Director of Nursing. There would remain four representative positions to the Area Clinical Forum as outlined. The joint Committee would meet on a monthly basis, from January 2010, in the week preceding NHS Board meetings so as to facilitate the scrutiny of Board papers, with Sub Groups meeting in the morning and the full Committee in the afternoon. It was stated that should the proposals be accepted a new Constitution and Terms of Reference would drafted for approval by the NHS Board. A full review of the new structure would take place one year after inception. Ms Catherwood requested that the Committee consider in particular aspects relating to membership, the provision of an advisory function, and the proposal for monthly meetings.
During discussion, it was stated that whilst Sub Groups may have a different membership from each other this would not be the case for the two elements of the Committee itself. Dissemination of decision making etc would be the responsibility of relevant Professional Leads. On the point raised Ms May stated that, in addition to inclusion in the membership of a Consultant Nurse, it was anticipated that AHP Consultants, once established would, be included. Ms H May stated that given the operational and other leadership issues involved there was a clear need to formalise the advisory element of the Committee. She added that monitoring and performance was crucial and as such there was a need for involvement of front line staff and the effective use of organisational structures within services/professions. This would also have the benefit of providing for strong succession planning and organisational awareness, which would also accrue from the attendance of representatives in the absence of members. Ms Dickson stated that representation would be an issue, especially for smaller professions and services. Dr Gibbins stated that obtaining the correct membership would be crucial to the success of any joint Committee and that the key aim would be to more fully undertake the prescribed advisory role within the NHS Board structure. A balanced membership between front line staff and relevant Leads would be beneficial. On the issue of member voting rights it was agreed that this would be required.
The Committee:
· Agreed in principle the proposals for a joint NMAHP Advisory Committee.
· Agreed issues relating to membership and scheduling be further considered.
· Noted that comments should be relayed to Ms Catherwood.
· Noted an update would be submitted to the December meeting of the Committee.
Dr R Gibbins left the meeting at 4.10pm. / ALL
ALL
JC
7. / HAI AND HAND HYGIENE AUDIT RESULTS
Ms H May spoke to the circulated Infection Control Report, which had previously been considered by the NHS Board. Particular attention was brought to the relatively high infection rate around repair of fracture neck of femur and in respect of which a multi-disciplinary plan was being developed. National guidance was awaited with regard to the SCRIBE tool for reducing risk in the built environment and the relevant tool was to be tested in October 2009, with the Head of Facilities leading in this area. With regard to the issue of Hand Hygiene the latest audit results had established a 92% compliance rate, new audit results were due to be published shortly, and rolling audits were to be introduced across the organisation. Auditory signage was to be installed following agreement to meet costs by the Endowment Funds Committee. Ms J Catherwood advised that Professional Heads of Service would be tasked with considering the potential impact of recent HPS documentation relating to infection control in the Community setting. It was stated that concern had been expressed in relation to equipment use in the Community setting and Ms H May advised that guidance, such as in relation to single usage, should be sought from Dr A Hay, direct from HPS, or through the Control of Infection Committee. Mr I Henderson referred to the proposed NHS Highland Dress Code, and in particular in relation to Medical staff and the wearing of white coats, and in response Ms Catherwood advised that further clarity on this point was expected to be received at the next meeting of the National Uniform Group. Ms M Moss referred to guidance relating to the wearing of rings and was advised that Ann McBeath would be able to assist on this point.